Ultiva

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Ultiva

OVERDOSE

As with all potent opioid analgesics, overdosage would be manifested by an
extension of the pharmacological actions of ULTIVA (remifentanil) . Expected signs and symptoms
of overdosage include: apnea, chest-wall rigidity, seizures, hypoxemia, hypotension,
and bradycardia.

In case of overdosage or suspected overdosage, discontinue administration of
ULTIVA (remifentanil) , maintain a patentairway, initiate assisted or controlled ventilation
with oxygen, and maintain adequate cardiovascular function. If depressed respiration
is associated with muscle rigidity, a neuromuscular blocking agent or a μ-opioid
antagonist may be required to facilitate assisted or controlled respiration.
Intravenous fluids and vasopressors for the treatment of hypotension and other
supportive measures may be employed. Glycopyrrolate or atropine may be useful
for the treatment of bradycardia and/or hypotension.

Intravenous administration of an opioid antagonist such as naloxone may be
employed as a specific antidote to manage severe respiratorydepression or muscle
rigidity. Respiratory depression from overdosage with ULTIVA (remifentanil) is not expected
to last longer than the opioid antagonist, naloxone. Reversal of the opioid
effects may lead to acute pain and sympathetic hyperactivity.

CONTRAINDICATIONS

Due to the presence of glycine in the formulation, ULTIVA (remifentanil) is contraindicated
for epidural or intrathecal administration. ULTIVA (remifentanil) is also contraindicated in
patients with known hypersensitivity to fentanyl analogs.

Last reviewed on RxList: 5/23/2008
This monograph has been modified to include the generic and brand name in many instances.